midwives and doulas

mitchsmom · Jul 7, 2006

Just wondering--for a hospital based birth, if a woman has a midwife, is a birth doula really necessary? Does a hospital based midwife essentially fill the role of doula/birth companion?
Thanks!

I would ask your particular midwife. The idea is that they are with you during your labor more so than an MD but in my experience they are not always actually able to be there the entire time, in that case a doula would be nice. There seems to be a wide range in hospital midwifery practice when it comes to aspects like this - though other contributors here may be able to add more.

Selke · Jul 7, 2006

Just wondering--for a hospital based birth, if a woman has a midwife, is a birth doula really necessary? Does a hospital based midwife essentially fill the role of doula/birth companion?
Thanks!

I think it depends on how the pt's midwife practices, so this must be discussed with her in advance. For example, does she stay with the pt throughout labor, providing labor support? Is the pt likely to be her only pt? Or does she show up closer to time of delivery? Does the midwife work with a large practice and share a call schedule where she may have several pts on the board at once? This precludes spending much time with an individual pt for labor support.

If the midwife stays with the pt throughout most of labor providing labor support, the pt probably doesn't need a doula, unless she has the financial resources to pay for, and she wants, the extra support. If the midwife's practice falls into the other categories, the pt may want to hire a doula, for continuity of support -- even if the nurses provide labor support, there is lack of continuity with shift changes, staffing patterns, pt load, &c.

tinyscrafts · Jul 7, 2006

IME, nope. a Hosptial based MW is more like an OB, they come in at the end and the labor is managed by the nurses. A doula is still a good idea :)

texas-rn-fnp · Jul 7, 2006

IME, nope. a Hosptial based MW is more like an OB, they come in at the end and the labor is managed by the nurses. A doula is still a good idea :)

The doula will hang out day and night to do those touchy feely personal attendant chores, whereas the midwife will function more like a doctor but more sensitive.

SmilingBluEyes · Jul 7, 2006

When we had midwives (right now the two we had are gone), there was no need for a doula, really. And we as nurses, really only helped the midwives and did a lot of paperwork. These two midwives were WONDERFUL about being there for active stages of labor and delivery. I sure do miss them.

Another place I worked, the midwives were like OBs with a different title. They "managed" their patients through us, with us doing all the primary care and support of their patients. They just basically came for the deliveries, really, just like OBs do. These folks sometimes did bring and definately benefitted, from their doulas being present.

CEG · Jul 7, 2006

My MW was hospital was in a large practice that took call. When she was on call she stayed in the hospital and provided continuous support. The problem was that with several patients in labor she was going back and forth, so a doula would be nice in a situation like that.

Looking back I wish I had had a doula, but I didn't think I needed one because I had a midwife:) (who was fabulous, just busy).

madwife2002, BSN, RN · Jul 7, 2006

I am a midwife in the UK and worked at two different hospitals two different ways.

I was a caseloading midwife where I took 36 women a year and apart from 12 weeks vacation I was on call 24 hours a day, 7 days a week. It was a new concept of working, and whilst be very tiring was very interesting.

I booked the women in their own home at 8-12 weeks then I did all their ante natal care in their own home. When they went into labour I was called in and I examined the women in their own home and then we went into the hospital together if she was progressing. They had my cell phone number and if I was on vacation then I would switch my phone through to my partner. I stayed with the women no matter how they had their baby, if it was natrually then I did the delivery if it was a c/s I scrubbed to catch the baby.

I was paid by the government there was 6 midwives involved we had a 36% home birth rate, which is unheard of. I have never been so tired in all my life, you would go for weeks with no calls then you would get labourers one after the other.